Permit 1 ..`. _. CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
,, ' `. COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00038
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/13/2007
PARCEL: 2S 102AA -04700
SITE ADDRESS: 08900 SW COMMERCIAL ST ZONING: CBD
SUBDIVISION: • MORINS ADDITION LOT: JURISDICTION: TIG
PROJECT: BALLROOM DANCE STUDIO
Project Description: Low voltage: audio and data
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
BROWN, DEAN A PERFORMANCE SYSTEMS INTEGRATION
PO BOX 583 7324 SW DURHAM RD.
CARLTON, OR 97111 PORTLAND, OR 97224
Phone: Contact #: PRI 503- 641 -2222
FAX 503- 641 -1464
FEES Reg #: ELE 34- 522CLE
LIC 150747
Description Date Amount
[ELPRMT] ELR Permit 2/13/2007 $150.00
[TAX] 8% State Surcha 2/13/2007 $12.00 REQUIRED ITEMS AND REPORTS
Total $162.00
i
This Permit is issued subject the regulations contained in the Tigard Municipal Code, State Ok\ Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952 - 001 -0010 through OAII 952-001-100. You may obtain copies of these
rules or direct questions Ito OUNC at 503.246.6699 or 1.800.332.2344. C^
Issued By: � Permittee Signature: { f C
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Applirc o i `, Foi.oi [ ICE USL OtiL1 `. •
... u U t
.3.
City of Tigard Dat In 0 • 10 Permit No.' / v_ /07 0O
" 13125 SW Hall Blvd., Tigard, 0i:19
C } t3 2007 Plan Review Other Permit
Phone: 503.639.4171 Fax: 50 �A 9 Date /B .
T 1 C A R D Inspection Line: 503.639.4175 Daze Ready/By: ® See Page 2 for
Internet: www.tigard- or. v�A y ur iit
ry 9PW i aN Notified/Method: Supplemental information
' � p e q A'1 PLAN REVIEW
El New construction , Addition/alteration/replacement Please check all that apply (submit 2 sets of plans whims checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION' exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE" INFORMATION AND LOCATION :JOB system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job site address: �jq p(� 100HP or more. occupancy.
Job no.:
102,63 p r J w ` Ci'ti �� ❑ Six or more residential units. ❑ Recreational vehicle parks.
❑ Health -care facilities
❑Hazardous locations. ❑ Supply voltage for more than
City / State/ZIP: 0� r v2 600 volts nominal.
Suite/bldg. /apt. no.: Project name: J tUr - 1)1 0 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE.
Cross street/directions to job site: Description I. Qty. I Fee. I Total I •
New residential single - or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
• Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
" ' DESCRIPTION OF WORK (with above sq. ft.)
`
/ Limited energy, multi - family 75.00 2
' L '5p� iks., -`t b�, r_,t xSt: residential (with above sq. ft.)
J Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
' ❑ PROPERTY OWNER 0 TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/ State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
(\APPLICANT I 0 CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
• Business name: / B. Fee for branch circuits
without service or feeder fee,
Lc2�n2t��rr �5�,�...3
Contact name: 46.85 2
�fYlleie.�/ first branch circuit
Address: 4 3 Z S(4) `� q�� F�=� Each add'( branch circuit 6.65 2
` Miscellaneous (service or feeder not included)
City/State/ZIP: 1!44 t 0 q37)0 Each manufactured or modular
90.90 2
41 dwelling, service and/or feeder
Phone: (()/ �)
641-V2/7-2,_ �
Fax: : (5) b Reconnect only 66.85 2
•
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: St
It'S /Q- S Si'LS energy panel, alteration, or
Address: extension. Describe: Page 2 2
• City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (1 hr min) 62.50
CCB Lie.: (50441 Electrical Lic. Suprv. Lic.: 3 b k4 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES • -
Suprv. Electrician signature, required: // � _ Subtotal:
. C Plan review (25% of permit fee):
Print name: Date' Z.
/�a9 4,4. • 13 '0-- State surcharge (8% of permit fee): /a--
Authorized signature: TOTAL PERMIT FEE: /CO3... ■
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
' Number of inspections allowed per permit.
1:\ Building \Pecmits\ELC- PermitApp.doc 05/23 /06 440- 4615T(I 1 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
• LIMITED ENERGY PERMIT FEES:
rik ONLY:. . -
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
p Other:
COMMERCIAL WORK ONLY: . ��
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
• Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PermitApp -doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EI.R2007-00038
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2113/2007
Phone: (503) 639-4171 tempA(
Inspection Requests (24 Hrs.): (503) 639-4175 .„--fi3O■
INSPECTION WORKSHEET FOR DATE: 6/14/2007 TIME: 7:01AM PAGE: 59
•
SITE ADDRESS: 08900 SW COMMERCIAL ST CLASS OF WORK:
SUBDIVISION: MORINS ADDITION LOT #: TYPE OF USE:
PROJECT NAME: BALLROOM DANCE STUDIO
DESCRIPTION: Low voltage: audio and data
OWNER: BROWN, DEAN A, PHONE #:
CONTRACTOR: PERFORMANCE SYSTEMS INTEGRATION PHONE #: 603.641-2222
Inspection Request Scheduled For: Date: 6/14/2007 Pour Time:
Code # Inspection Description # Contact # Message
199 Electrical final 048181-01 "503-969-6949
Corrections/Comments/Instructions:
N
N
\ ) 1 \
\
•
\ PASS fl PARTIAL APPROVAL LII CANCEL fl NO ACCESS
I l FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: 1\ L1 ;111101 Phone #: (503) 718-
.• • . .
.
CITY OF TIGARD ,
BUILDING DIVISION A ' PERMIT #: ELR2007 -00038
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/13/2007
Phone: (503) 639 -4171 tii�giigq ��l+�
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' __..
INSPECTION WORKSHEET FOR DATE: 5/11/2007 TIME: 7:01AM PAGE: 86
SITE ADDRESS: 08900 SW COMMERCIAL ST CLASS OF WORK:
SUBDIVISION: MORINS ADDITION LOT #: TYPE OF USE:
PROJECT NAME: BALLROOM DANCE STUDIO
DESCRIPTION: Low voltage: audio and data
OWNER: BROWN, DEAN A, PHONE #:
CONTRACTOR: PERFORMANCE SYSTEMS INTEGRATION PHONE #: 503 - 641 - 22 . 22
Inspection Request Scheduled For: Date: 5/11/2007 Pour Time:
Code # Inspection Description nfrrm #Z Contact # Message
199 Electrical final 048123 -01 503 - 969.694'. \ Y
Corrections /Comments /Instructions: _ - Ok '�
L,S - ?Mo\ t, Dom' s pi.:17 (30 I, eia N it 1 101
Fr Q1 iO N 6f .141) To. 'Icy G urn w►(sc5 ,
6) ci:)I L -1 ( 1c niNT■Vda bF crirsotb ua►►C
� \ rN j (SL, -'( -Alm cssN5o1.
I I PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
!+ FAIL . 7CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: a bed Date: 611.1I 1 Phone #: (503) 718- 1-44
— .
CITY OF TIGARD , _
1 BUILDING DIVISION PERMIT #: ELR2007-00038 .,
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/13/2007
Phone: (503) 639-4171
I karilogti i t:1,
Inspection Requests (24 Hrs.): (503) 639-4175 , °IL
INSPECTION WORKSHEET FOR DATE: 5/10/2007 TIME: 7:02AM PAGE: 51
SITE ADDRESS: 0R900 SW COMMERCIAL ST CLASS OF WORK:
SUBDIVISION: MORINS ADDITION LOT #: TYPE OF USE:
PROJECT NAME: BALLROOM STUDIO
DESCRIPTION: Low voltage: audio and data
OWNER: BROWN, DEAN A, PHONE #:
CONTRACTOR: PERFORMANCE SYSTEMS INTEGRATION PHONE #: 503-641-2222
----- Tiispec ion Recyest Scheduled For: Date: 5/10/2007 Pour Time:
Code # / Inspection Description Confirm # Contact # Message
199 Electrical final 048009-01 503-969p6949 N
Corrections /Comments/ Instructions:
) CO PkeViDric ' 6 G-ko ut.Sb w7aits 1'a iettsittL1/4 hqs:TAL,
CZfNc.V-.. /50 MX 2-2. ) 14014'0 - 44•0--(w6".-
Ko ts:s.loo.
fl PASS 0 PARTIAL APPROVAL I I CANCEL 0 NO ACCESS ,
A FAIL X CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CY1r K (v5 LE Date: 6 01 Phone #: (503) 718- IA
CITY OF TIGARD . ..
BUILDING DIVISION ..... ‘... , -- PERMIT #: ELR2007-00038
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/13/2007
Phone: (503) 639-4171 4 0110I e,-
Inspection Requests (24 Hrs.): (503) 639-4175 AA Ail.
INSPECTION WORKSHEET FOR DATE: 2/2112007 TIME: 7 PAGE: 15
SITE ADDRESS: 00900 SW COMMERCIAL ST CLASS OF WORK:
SUBDIVISION: MORNS ADDITION LOT #: TYPE OF USE: ,
PROJECT NAME: BALLROOM DANCE STUDIO
DESCRIPTION: Low voltage: audio and data
OWNER: BROWN, DEAN A, PHONE #:
CONTRACTOR: PERFORMANCE SYSTEMS INTEGRATION PHONE #: 503
Inspection Request Scheduled For: Date: 2/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 043678-01 503-96M949 N
Corrections/Comments/InstrUctions:
294. okL Roollik-
c--: p
fi \ PASS fl PARTIAL APPROVAL 7 CANCEL U NO ACCESS
7 FAIL 7 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: .-- r 6 5 t--- k)
Date: 1 -- 1 4 ( ) Phone #: (503) 718-